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Staying Alive > MCQ 1 > Flashcards

MCQ 1 Flashcards

1
Q

Methyldopa

A

Central alpha 2 agonist

Decrease blood pressure

Given to pregnant women with high blood pressure

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2
Q

Atropine

A

Non selective muscarinic antagonist

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3
Q

Carvedilol

A

Non selective beta 1 and alpha1 antagonist

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4
Q

Terazosin

A

Selective alpha1 antagonist

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5
Q

Epinephrine

A

Low dose: beta1 and beta2&raquo_space; alpha1

High dose: alpha1» beta 1 and beta 2

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6
Q

Cardiovascular response to Epinephrine

A

Increased heart rate and contractility = beta activity

Increased vasoconstriction = alpha1
Epi (low dose) causes a fall in peripheral resistance and DBP due to predominant beta 2 vasodilation.

The rise of SBP is a combination of peripheral vasoconstriction (alpha) and direct cardiac stimulation (beta 1).

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7
Q

Propronolol

A

Beta1 and beta2 antagonist = beta1 (decreases HR and contractility) beta2 ( vasoconstriction)

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8
Q

Phenylephrine

A

Alpha1 agonist

Decreases HR and increases MAP

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9
Q

Cardiovascular response to phenylephrine

A

Increased: MAP, SBP, DBP
Deceeased: HR (reflex bradycardia

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10
Q

What would induce increased Bp and SBP?

A

Alpha1 and beta1 activation

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11
Q

What would induce increased DBP?

A

Alpha1 activation

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12
Q

What would cause decreased HR?

A

Beta1 blockage, direct M2 activation, or baroreceptor reflex response to increase Bp

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13
Q

Isoproterenol

A

overall decrease in MAP and DBP due to beta2 stimulation with a small increase in SBP. HR increased by beta1 stimulation when administered alone.

Isoproterenol is both a beta 1 and beta 2 agonist that lowers peripheral resistance as well as DBP via beta 2 mediated peripheral vasodilator actions. The fall of DBP is > than the rise of SBP due to the direct cardiac beta 1 activating effect. Mean arterial pressure falls a bit due to this mismatch. The combined reflex response to the decrease in MAP with the drug’s direct positive chronotropic effect leads to significant tachycardia.

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14
Q

phentolamine

A

alpha blocker

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15
Q

cardiovascular response to atropine

A

-increased HR

Used to treat bradycardia

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16
Q

Norepinephrine

A

alpha1 and beta 1 agonist (mostly alpha1)

Decreases heart rate
Increases MAP

-vasoconstrictor (increases bp) that it triggers the baroreceptor reflex (increases MAP) and causes reflex bradycardia.

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17
Q

phenoxybenzamine

A

Irreversible alpha-antagonist

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18
Q

neostigmine

A

increased acetylcholine which leads to slowing down heart

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19
Q

midodrine

A

alpha1 agonist

20
Q

cardiovascular response to midodrine

A

increased map, sbp, dbp

decreased HR

21
Q

Acetylcholine

A

at pharmacologic doses, ACh will stimulate M2 receptors in the heart ↓ HR and M3 receptors on the vasculature to cause vasodilation and slight ↓MAP which would not trigger the reflex

22
Q

Dobutamine

A

– beta1 agonist – increase HR and small increase in MAP

23
Q

How do antihistamines work?

A

By increasing cAMP formation

24
Q

What are the effects of Histamine?

A 
Causes vasodilation (decrease in BP), increased vascular permeability, erythema,
congestion, edema, and inflammation, pruritis (if H1 receptor on the mucocutaneous
nerve endings), bronchoconstriction leading to decreased lung volume, and coughing
25
Q

Inhaler used for seasonal AR, blocks influx of calcium into mast cells

A

cromolyn: Stabilize the plasma membranes of mast cells and eosinophils to prevent degranulation
and release of histamine, leukotrienes, and other substances that cause airway
inflammation

26
Q

what is the mechanism of fexofendaine?

A

histamine antagonist/inverse agonist

second generation: Doesn’t cross blood brain barrier

27
Q

What inhaler is given for immediate relief of shortness of breath

A

albuterol- b2 receptor agonist

28
Q

stimulation of B2 receptor causes what GPCR action?

A

increase in cAMP (Gs)

29
Q

What is the effect of montelukast?

A

competitive antagonist of the CysLTI receptor

works on Gq, decreasing IP3 —> decrease in smooth muscle contraction

30
Q

What is the mechanism of tiotropium?

A

muscarinic receptor antagonist (M3) (Gq)

31
Q

what respiratory medication is associated with a blood pressure change?

A

Pseudoephedrine -vasoconstriction

32
Q

Why would Zileuton be chosen over montelukast?

A

Zileuton inhibits LOX and prevents all leukotriene formation (including LB4)

33
Q

Ambrisentan is used for pulmonary hypertension. What is the MOA?

A

inhibits type A endothelin

34
Q

What medication causes drowsiness?

A

Hydroxyzine; first generation antihistamines

35
Q

Name first generation antihistamines

A

Distributed in the CNS (cross blood-brain barrier) and cause sedation. Can treat N/V and prevent motion sickness and treat vertigo

Clemastine
Chlorpheniramin
Doxepin
Diphenyhydramine 
Dimenhydrinate
Hydroxyzine
Promethazine
Meclizine
36
Q

second generation antihistamines

A

don’t cross the blood brain barrier

Cetirizine
Desloratadine
Fexofendaine
Levocetirizine
Loratadine
37
Q

Person with elevated IgE will be placed on what medication?

A

Omalizumab: An IgE antagonist that binds to free IgE

38
Q

What is the mechanism of action of roflumilast?

A

Inhibits PDE4 in lung tissue to treat COPD. No use in acute episodes

Increases cAMP because phosphodiesterase breaks down cAMP

May cause diarrhea, nausea, and weight loss, some psychiatric effects (anxiety, insomnia,
and depression)

Given orally qd and has good oral bioavailability

39
Q

What antitussives won’t cause drowsiness?

A

dextromethorphan: works on central cough center

40
Q

What is the function of Lumacaftor?

A

A chaperone drug that brings the defective CFTR protein (Cl- channel) to the cell surface (traffics it to
the cell surface)

41
Q

Pt on Theophylline just stopped smoking and feels bad. what is Theophylline level and change in metabolism due to stopping smoking?

A

Theophylline level increased and metabolism decreases (causes insomnia)

42
Q

Pt taking a Theophylline w/a H2 blocker blocks metabolism of theophylline. Also recenglh stopped smoking. What is he at risk for?

A

seizures

43
Q

Pt with shortness of breath on carvedilol and tiotropium/albuterol. Why is she having symptoms?

A

competition for B2 receptors

carvedilol: a1, b1, b2 antagonist
albuterol: b2 agonist
tiotropium: M3 antagonist

44
Q

What medication helps thin mucus secretions?

A

Guaifenesin (expectorants-Facilitates the coughing up of mucus and other material from the lungs.)

45
Q

What medication inactivates IL-5?

A

Reslizumab: Inactivates IL-5 and prevent it binding to receptors on eosinophils causing a lower blood
and sputum eosinophil level and reduced airway inflammation. IgE blocker

Staying Alive (1 decks)

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